Environment and Natural Resources

By Wondwossen Gebreyes, DVM, PhD
Ohio State College of Veterinary Medicine

As I said in my previous post, we learned many things from each other during this successful Summer Institute. Here are a few of my thoughts on specific topics.

Maximum flexibility and minimum expectations: This became the motto for the team members a couple of days after we arrived. Considering the resource limitations of Ethiopia, the high economic growth and resulting traffic jams, and limitations in communications, one may not be able to plan things well in advance, or keep your lane consistently in driving on the highways, or be able to arrive for meetings on time.

At the end of the day, we always achieve all the goals, and everyone gets to be happy, though not in the most efficient way.

The situation also made me realize how much building capacity in the area of effective communication could improve all the activities we conduct in this partnership, be it neurosurgery, nursing, or environmental health.

Effective communication and filling the gap within our partner institutes in Ethiopia is critical.

However, life in the U.S. made us become very sensitive. We often try to be perfect. Ethiopia was a great venue for most to realize the sky does not fall. It is OK to be a bit late.

Relax, and still achieve our goals!

Equipment. Equipment, Equipment: As we all witnessed during our several meetings at the various health science colleges of the two universities and also read in blogs, one key ingredient missing very much in the hospitals, research, and teaching settings is equipment.

During this trip, I learned first-hand that 44% of the patient cases at the nation’s premier referral hospital, the AAU Black Lion Hospital, were cancer cases. It was sickening to also learn that among these cases, 65% were pediatric. Yes, indeed there is lack of manpower, and so we launched the institute.

The partner universities are also building the physical infrastructures. While these address part of the issue, the lack of equipment is a major impediment for capacity-building. How can one radiotherapy machine can handle such a large cancer case burden for 85 million-plus population?

Equipping laboratories and clinical units remains a major challenge that partners in Ethiopia and Ohio State will have to tackle.

Maximum motivation: I never realized so clearly until this trip what drives my passion in global work, particularly the teaching aspects. Never fully understood what drives me to lecture several hours with only a short tea break and still have the full steam.

I observed my colleague, Dr. Bisesi, give his lecture on environmental health, and I saw the wide open-eyed trainees and their interaction. I noticed the high level of motivation by the trainees. The same was true for my course.

Students were so highly motivated that they even asked me to teach a full day on a Saturday. Some even suggested we keep going on Sunday, but that idea created a bit of a stir. “True,” I said in my heart, “that is a big NO in Ethiopia.”

You have to respect Sabbath day more than molecular epidemiology.

The Ferenji Effect: Ferenji is defined very loosely as “a foreigner,” particularly referring to a rich Caucasian. Its connotation is very positive. Ferenji is often considered as a nice, generous foreigner whose pocket carries endless amount of treasures … well, we all know the truth.

Typically Ferenjis are magnets to Ethiopian kids in urban and rural areas of Ethiopia; they often have chocolates, coins, and all kinds of fun things. At a minimum they have a digital camera to snap kids’ picture and show it back to them. The kids giggle seeing their own image in this small window. They followed Dr. Bisesi and Mr. Harrison as we traveled in a suburb of Addis.

During the Summer Institute, I witnessed the usual hospitality of the university security guards and others giving the due respect to our “guest Ferenjis” and I (the designated local chauffeur) also get a free ride.

Unlike what I stated above, about “Ferenji are magnets to local kids,” kids in the Woreta area acted differently. When we were collecting questionnaires for the rabies project, the kids would run away when they saw our giant, “tall-6-foot-some” great athlete and health science student, Korbin Smith. “They might have considered him as Goliath,” I thought to myself. I also hoped one of those little shepherd kids would not be like Dawit (David). Thankfully, we left the place with all fun and no fighting.

By Wondwossen Gebreyes, DVM, PhD
Ohio State College of Veterinary Medicine

It has been wonderful working with all the Ohio State and Ethiopian faculty and students during the One Health Summer activity that run from June 7th to this week.

First off, I am very much proud to be a Buckeye. Everyone from the Buckeye nation (Ohio State) showed wonderful professionalism throughout the Summer Institute.

I heard all positive words from our partners in Ethiopia. Students and faculty from five of our seven health science colleges and also School of Environment and Natural Resources have all been great to work with.

I am also proud to be born Ethiopian. I am sure all my colleagues tasted the ultimate hospitality and motivation both in classrooms and social settings and learned a great deal of variations in traditions.

The commitments from both student trainees and partner administrators has been unsurpassed. It gives me a great pleasure seeing the trainees’ eyes wide open in the various lectures, sharing the Ohio State students’ excitement for service learning (even some requested opportunities for next year before leaving Ethiopia), and reading all the blog posts from our students and faculty members.

Importantly, personally, I also learned few more things about Ethiopia and partnership along the way.

With respect to the scientific/ technical aspects of the Summer Institute, I am confident to say that we achieved the goals – in all aspects: coursework and trainings, pilot projects, and workshops. We were able to impact more than 200 professionals in these courses. And a number of scientific networks and new collaborative partnerships developed. Partner colleges were able to identify areas for further collaboration.

Both the Univeristy of Gondar (photo below) and Addis Ababa University partners as well as other institutes — such as the Ethiopian Health and Nutrition Research Institute (EHNRI) — were excited with the outcome.

It was humbling to hear from the dean of AAU School of Medicine, Dr Mahlet, I quote: “We thought Ohio State would be similar to many, many universities we signed MoU with before and never heard from them again. You made us feel guilty by showing your commitment in a short period of time. Thank you and we are also determined to show our commitment.”

As we move forward, the Ohio State Health Sciences task force will resume its activity in full force. On behalf of the Ohio State Health Sciences One Health task force, thank you to all those who participated in the Summer institute! Some of the upcoming activities will include visits by the Ethiopia partner universities delegation; continued pilot projects on cervical cancer screen-and-treat, rabies intervention, electronic capacity-building, and service-learning clinical activities by neurosurgery and nursing teams. Please stay tuned and follow our blog.

In my next post, I will share some specific thoughts and observations on these activities.

Since my arrival on July 7, we have accomplished several activities. As an environmental health scientist, I was able to teach applicable modules to a wonderful group of grad students, clinicians (veterinarians, physicians, nurses) and scientists.

Addis Ababa University students listen as Dr. Bisesi lectures.

The modules included lectures and discussions regarding the properties of various environmental matrices (air, water, soil) and the fate of microbial and chemical contaminants that can adversely affect plants, animals, and humans.

An extension from the classroom included a field trip and qualitative assessment of the waste water treatment facility for the city of Addis Ababa. This was very enlightening since it demonstrated a system that has insufficient capacity for the volume of polluted waste water originating from municipal, industrial, hospital and runoff sources. The surrounding adjacent areas had fields growing crops, animals drinking and feeding, and humans using this area as a resource.

This river runs through the Kera region of Addis Ababa. People use the river to irrigate crops.

Field hands work near a large amount of foam caused by water pollution in the Kera region of Addis Ababa.

I also visited the slaughterhouse and tannery which have some pollution control technologies and practices in place. Observation of the river and surrounding land confirms suspicions that multiple sources are contributing to environmental pollution that impacts animal and human health. Our integrated approach to address this will bring results, but much work lies ahead. Our Ethiopian partners are wise to have included this work as a priority for our partnership.

Student, Ohio State College of Food, Agricultural, and EnvironmentalSciences; School of Environmental and Natural Resources

Soon after arriving in Addis Ababa, I had the opportunity to give a lecture on risk perceptions to students attending the summer institute. As my driver took me from my hotel to the university, I realized that traffic laws are merely a suggestion here, and pedestrians cross anywhere they can find a break in the traffic. My driver explained that the road we were on went from Addis to Djibouti, so it was constantly busy. Trucks full of construction materials, minibuses used for public transport, and small passenger cars jostled for position, while rickshaws led by mules stayed largely to the side and out of the fray. Needless to say, I was thankful for a driver who knew the unwritten rules of the road!

Once I arrived at the university, I had a bit of lunch, and then I was off to lecture. Throughout the lecture, I asked the students for examples of risk perceptions from Ethiopia, and one student mentioned traffic deaths. At the end of the lecture, we spent some time discussing strategies that had failed and what future efforts to reduce traffic deaths might look like. It was a very rewarding experience having engaged students interested in applying knowledge, and learning about applications within their culture. It’s always wonderful when the learning goes both ways in a classroom!

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